WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Ahmed Mahmod Mohammed* and Ibrahim Shukur Mahmood

ABSTRACT

Background: Capillary hemangiomas can be treated in different ways depending on the location of the hemangioma, how large it is, and whether or not it is causing vision problems. Currently available treatment options include laser therapy, surgery, chemotherapeutic drugs (bleomycin, vincristine, and alpha-interferon), systemic or intralesional corticosteroids, or a mix of them. Every choice has certain restrictions because of negative consequences. Objectives: Is to compare the efficacy of intralesional bleomycin and intralesional triamcinolone among non-responders to propranolol therapy in terms of size reduction and side effects. Methods: A nonrandomized controlled trial was conducted in the Department of Pediatric Surgery at Ibin Al Atheer Hospitals, from January 2024 to February 2025. The study included children aged 0-14 years with uncomplicated cutaneous capillary hemangiomas who presented to the outpatient department or were admitted to the hospital. The study excluded children with infected hemangiomas, solid organ hemangiomas, contraindications to oral propranolol and prior treatment for the same lesion. The questionnaire includes five sections, section one for demographic information, section two for intervention used, section three for patient clinical presentation information and section four for response details of the lesion and part five for complication of the intervention used. Results: The study included 148 infants with infantile cutaneous hemangioma. Of them; 98 (66.22%) patients were respond to propranolol treatment, while 30 (20.27%) patients are partial respondents and 20 (13.51%) patients were not respond to propranolol treatment. Among the patients with inadequate response (partial and non-respondents) which are 50 patients, the mean ± standard age was 3.23 ± 0.71 years. The majority of them (64%) are from the age group of less than 1 year. Moreover; 31 (62%) patients were females and 19 (38%) were males with female to male ratio was 1.63. Bleomycin shows better response rate than triamcinolone (P value <0.001). With significantly less dose of drug need for bleomycin group (P value <0.001). Conclusion: In children with partial or no response to oral propranolol, intralesional bleomycin is more effective than intralesional triamcinolone. Triamcinolone and propranolol may have similar mechanisms of action when compared to bleomycin, as non-responders to propranolol may similarly have poor reactions to triamcinolone. Bleomycin could offer extra benefits to those on propranolol.